ABSTRACT Insulin binding to its receptor results in receptor autophosphorylation on tyrosine residues and the tyrosine phosphorylation of insulin receptor substrates (IRS-1, IRS-2 and IRS-3) by the insulin receptor tyrosine kinase. This allows association of IRSs with the regulatory subunit of phosphoinositide 3-kinase (PI3K) through its SRC homology 2 (SH2) domains. Once activated, the catalytic subunit phosphorylates phosphoinositides at the 3′ position of the inositol ring or proteins at serine residues. PI3K activates PtdIns(3,4)P2 / PtdIns(3,4,5)P3-dependent kinase 1 (PDK1), which activates PKB/Akt, a serine kinase. PKB in turn deactivates glycogen synthase kinase 3 (GSK-3), leading to activation of glycogen synthase and thus glycogen synthesis. Activation of PKB also results in the translocation of GLUT-4 vesicles from their intracellular pool to the plasma membrane, where they allow uptake of glucose into the cell. PKB also leads to mTOR-mediated activation of protein synthesis by PHAS/elf4 and p70s6k.